Download Osteoporosis

Osteoporosis
By: Renee Alta
Pathophysiology/Etiology
• Characterized by low bone mass and
structural deterioration of bone tissue,
leading to bone fragility and an
increased susceptibility to fractures,
especially of the hip, spine and wrist.
However, any boy can be affected.
• It is also the reduction of the mass of
bone per unit of volume.
Risk Factors
• Personal history of
fracture after age 50
• Current low bone mass
• History of fracture in
first degree relative
• Being thin and/or
having a small frame
• Advanced age
• Vitamin D deficiency
• Low testerone levels in
men
• Estrogen deficiency as
a result of
menopause, especially
early or surgically
induced
• Abnormal absence of
menstrual periods
(amenorrhea)
• Anorexia nervosa
• Low lifetime calcium
intake
Risk Factors
• An inactive lifestyle
• Use of certain
medications
–
–
–
–
Corticosteroids
Chemotherapy
Anticonvulsants
Antacids containing
alumin
– Heparin
– Cyclosporine
(immunosuppressive
drug)
• Current cigarette
smoking
• Excessive use of
alcohol
• Being Caucasian or
Asian
Clinical Manifestations
• Osteoporosis is often called the
“silent disease” because bone loss
occurs without symptoms
• Collapsed vertebrae may initially be
felt or seen in the form of severe
back pain, loss of height, or spinal
deformities such as kyphosis or
stooped posture.
Assessment
• Subjective Data
– Questioning
complaints of back
pain (low thoracic
and lumbar) that
worsens with
straining
– Questions that
include lifestyle
practices
• Objective Data
– Assessing for
Dowager’s hump
– Increases lordosis,
kyphosis, and
scoliosis
– Gait impairment
associated with
inability to maintain
erect posture
Diagnostic Tests
• Bone Mineral Density
Tests
– Detects osteoporosis
before a fracture before
a fracture occurs
– Predicts chances of
fracturing in the future
– Determines the rate of
bone loss and/or
monitor the effects of
treatement
• Complete Blood count
• Serum calcium,
phosphorus, and
alkaline phosphatase,
blood urea nitrogen,
creatine level,
urinalysis, liver and
thyroid function
• X-ray
• DEXA
Medical Management
• Biphosphonates
– Fosamax and
Fosamax plus D
– Boniva
– Actonel and Actonel
with Calcium
– Miacalcin
• Estrogen/Hormone
Therapy
– Estrogens
– Estrogens and
Progestins
– Parathyroid
Hormone
Surgical Interventions
• Vertebroplasty and kyphoplasty-relieves pain
from compression fractures of the spine
• Vertebroplasty involves high-pressure injection
of a polymethyl methacrylate cement into the
spine, which pushes the spine apart
• Kyphoplasty involves the use of a balloon that
is inserted into the center of the collapsed
vertebrae, which restores the position of the
vertebrae so that polymethy methacrylate
cement can be injected into the space created
by the balloon.
Nusing Interventions
• Nursing interventions are aimed at
preventing further bone loss and fractures
– Providing a diet rich in milk and dairy products
for an increase in calcum
– Estrogen therapy
– Safety measures, such as side rails, hand rails,
bedside commodes and mats in the shower to
prevent falls
– Encourage weight-bearing exercise to increase
bone density
– Exercises such as swimming, bike riding or
swimming.